By: Arunima Himawan

People from Black, Asian, and Minority Ethnic (BAME) backgrounds have been disproportionately impacted by the coronavirus. Among BAME communities, older adults – one of the most disadvantaged and excluded groups in society – were always likely to be hardest hit during the crisis. In an ageing society increasingly diverse in terms of characteristics, experiences and life trajectories, we shouldn’t have been surprised. It was clear that a range of pre-existing health and socio-economic factors were likely to put older BAME communities at greater risk from the coronavirus, and public health officials and politicians should have put in place a series of protective policies much earlier. They had been forewarned. 

It has been well evidenced that BAME communities are much more likely to be living in overcrowded and/or multigenerational households than their white counterparts. BAME people are also more likely than white people to live in densely packed and economically deprived urban areas. Indeed, Birmingham and the London Borough of Newham, who have seen some of the highest death rates in the country, have large BAME communities, including many older adults living with or near their family members. 

In addition, BAME people are highly likely to be employed in frontline and essential sectors such as the NHS; care work; the transport sector, such as bus drivers and taxi drivers; or in the food and service industry. Since older BAME adults are more likely to be in work than their white counterparts, they will be particularly vulnerable to the virus.   

There is also extensive evidence, including analysis by ILC-UK, showing that older BAME people are more likely to in be in poor health. Additionally, they are more likely to have age-related conditions, such as hypertension, diabetes, and being overweight that increase the risk of experiencing severe symptoms and complications from the virus. A further complication is they are often facing cultural and language barriers to accessing health services. 

What happens next
It is clear that in responding to the crisis the government has not considered the conditions in which BAME communities live and work, their health status and the barriers they face accessing public health services.   

When the country was placed under lockdown and social distancing was implemented, policy makers should have recognised that the reality of BAME people’s living conditions would make it challenging for them to implement those measures and that they would be more likely to be exposed to the virus. When those in occupations with heightened risk of exposure continued to work, despite being unable to access coronavirus tests or proper personal protective equipment, their health and safety were not a priority for politicians. To address these problems, when the government granted additional funding to local authorities, they should have allocated greater funding to those regions with higher BAME populations and higher levels of deprivation. Similarly, additional funding to local charities providing vital support to the BAME community, and in deprived areas such as delivering food and essential items should have been prioritised. Looking forward, it is crucial that the right support structures be put in place to help BAME people access voluntary sector support, And we must also ensure that the health system make it a priority to help BAME people build the confidence to navigate the health system. 

When devising policies, the government will need to be more forward-thinking and offer stronger projections, to ensure minimal damage to the health of the British population. For example, as lockdown eases, BAME people – many of whom work in the service industry, the sector worst affected by the lockdown – will likely return to work out of economic necessity and risk being exposed to the virus. Protective measures must be put in place, so they feel safe to return to work, or, wherever they do not feel safe, have the opportunity to delay their return without fear of losing their job.   

Last week’s Public Health England (PHE) review has confirmed the causal inequalities within BAME communities, without effectively addressing them.   

Absent from the PHE review is a clear set of recommendations for public health officials and politicians to intervene immediately to support the BAME community. Ethnicity is an important component of diversity, and we must ensure that BAME voices and experiences are heard and – most crucially – acted on.   

A second review is already underway, led by Junior Equalities Minister Kemi Badenoch. The review must recognise the underlying health and social inequalities causing BAME people to be disproportionately impacted by the coronavirus, as well as recommend actions to address them effectively. We must not be complacent, either during the crisis or as the country works to get back to normal, otherwise we run the risk of failing the BAME community again.